Quality Assurance

Question 1

define quality contol

Answer 1

specific measures for ensuring and verifying quality of radiographs produced

Question 2

define quality audit

Answer 2

process of external reassurance and assessment that quality control/assurance mechanisms are satisfactory and work effectively

Question 3

according to IRMER 2000, who must know quality assurance/ control

Answer 3

practicioners, operators (even if only in film processing)

Question 4

6 essential procedures within dental radiology QA program

Answer 4

• image quality
• patient dose and x ray equipment
• darkroom/daylight hood, image receptors, processing, image viewing
• working procedures
• training
• audit

Question 5

% and descriptions of Subjective Quality Rating

Answer 5

1: excellent, no errors of exposure/positioning/ processing 70%
2: diagnostically acceptable, some errors but do not detract from the diagnostic utility of the radiograph 20%
3: unacceptable, errors which render the radiograph unacceptable 10%

Question 6

what to include in film reject log 5

Answer 6

date
nature of film fault 
-cause and corrective action
-number or repeat radiographs
-total number of radiographs  in a specific time period --> can calculate % grade 3 films

Question 7

define quality assurance WHO

Answer 7

organised effort by the staff of a facility to ensure that the diagnostic images produced are of sufficiently high quality so that they consistently provide adequate diagnostic info at the lowest possible cost and least possible exposure of the patient to radiation

arrangements to ensure quality control measures are effective and they can lead to a relevant page

Question 8

chapter 5 guidance notes

Answer 8

• QA program mandatory
• must be reported
• responsibility of named person: define freq of operations, content of supporting records, freq of formal checking of records

Question 9

initial checks of x ray equipment 2

Answer 9

• critical examination by installer
• acceptance test before equipment used clinically to establish baseline performance inc measurements to assess representative pt dose. responsibility of named legal person

Question 10

how often should x ray equipment be checked/ types of checks 3

Answer 10

• daily checks, record findings (surgery staff)
• regular service/ maintenance checks (engineer)
• routine tests by physicist: every 3yrs. responsibility of legal person, to complement regular maintenance checks

Question 11

3 reasons physicist routine tests may be done annually

Answer 11

• assessed dose exceeds DRL
• failure to meet image quality targets
• performance weakness identified through QA

Question 12

when is re-examination report by physicist needed 3

Answer 12

if equipment is:

• relocated
• modified
• repaired

Question 13

5 things to include in equipment log

Answer 13

• what equipment (manufacturer, model number, identifier/serial number, year of manufacture, date of installation
• installation checks
• routine tests (chronological order)
• maintenance records
• repairs

Question 14

how often to check darkroom/ daylight hood

Answer 14

daily: cleanliness of work surfaces/ daylight hood/ film hangers
6-12 monthly 4:
-light tightness
-condition ofsafelights/daylight hood filter
-correct filter, no cracks
distance from work surface

Question 15

how to test if daylight hood is safe

Answer 15

coin test

Question 16

5 things to ensure for x ray film storage

Answer 16

• cool dry place
• away from sunlight and ionising radiation
• store on side
• rotate stock
• careful handling

Question 17

how to check for film-screen contact

Answer 17

graph paper/scatterguard between screens

• -> take radiograph
• -> check lines are clear on both side

(also clear regularly with proprietary cleaner)

Question 18

how to care for digital image receptors

Answer 18

every month 3:

• visual inspection of plates
• check cables and sensors
• clean plates if necessary

Question 19

how/how often to check image uniformity

Answer 19

every 3 months

• use low exposure
• view with narrow window

Question 20

how to monitor x ray set for deterioration 4 stages

Answer 20

• radiograph with test tooth with standard settings/distance
• process film in fresh solutions to produce STANDARD REFERENCE FILM
• repeat daily and compare
• record results

Question 21

summary of:

a. every day checks
b. every week checks
c. every fortnight checks
d. every 6 month checks
e. annually
f. every 3 months

Answer 21

summary of:

a. every day checks: solution levels, change water in wash tank, cleaner film, check chemical deterioration
b. every week checks: clean rollers
c. every fortnight checks: change chemicals, wash transport mechanisms and tank
d. every 6 month checks: coin test
e. annually: service machine
f. every 3 months: monitor checks eg greyscale, resolution, distance/ angle calibration

Question 22

3 things to include in audit

Answer 22

• QA program and associated records
• justification and authorisation of radiographs
• clinical evaluation of radiographs